We have a theory that all our bad habits in practising dentistry come from either dental school, where we rarely work with a qualified nurse, or from our first job where we have to accept the surgery design and working practices already in place and have no control.
Just think about it. By definition, if you work without a nurse or with a dental colleague who has no nursing training, you will naturally sit at the 12 o’clock position behind the patient, have drills delivered on your right side (if right handed) and aspiration on the left side. In order to see upper teeth, drill and aspirate all at the same time, you will bend over to use direct vision. Equally we position our instruments on our working side in order to access them ourselves.
This whole set up becomes ingrained in our psyche and follows us for the rest of our careers. Hence this baggage leads to the present day design of most surgeries by both dentists and dental suppliers.
We also just consider cabinetry arrangement as “a have space will fill it “ concept and rarely ask our nurses their opinion and it usually ends up around the walls of the room in a U or L shape with distances from the headrest of the chair not usually accounted for in any scientific way.
This is our “Baggage”
- Is this the most efficient way to do our dentistry?
- Is this a healthy way of doing dentistry?
- Can our nurses see what they are doing?
- Can we see what we are doing?
- Is it an efficient, ergonomic way of working?
We suggest the answer to these questions is an emphatic – NO
So what happens is that: –
Your Actual Performance = Your Potential minus Your Past Baggage
We all have so much more potential if only we just sat down quietly and thought it through.
So, play that Inner Game of Dentistry. Close your eyes and imagine the perfect performance you and your nurse could do in practicing your dentistry truly ergonomically.
You will come up with some surprising answers such as moving the instruments to the nurse side, having less cabinetry, have it all within arms reach of both you and your nurse etc.
It will involve change – few people like that. To do this we must unfreeze our habits, learn a new technique, practise it and then finally freeze it back into our brains so that it becomes the norm.
It may also involve redesigning your surgery so there is a cost.
If you do decide that moving the instrument tray to behind the patient where both you and your nurse can access it is a good idea then you will have to overcome some of the objections.
“ I don’t know what instrument I want, neither does my nurse so it’s slower”
“ My nurse isn’t always chair side”
“ There is nowhere to put it”
“ I am a control freak”
“ We might drop an instrument”
I am sure you can think of many more.
Equally consider some of the benefits
- Better cross infection control
- Ergonomic working during a procedure
- If you use loupes you don’t have to look away from the mouth in order to pick up an instrument
- Better teamwork appreciated by patients
- Your nurse is more involved in the procedure
- Much more efficient for the nurse to clear up at the end of a procedure